Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The REVEAL (Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension Disease Management) Risk Score is a clinical calculator specifically designed for patients with pulmonary arterial hypertension (PAH). This scoring system is used to predict the one-year survival rate of patients with PAH, thereby assisting clinicians in risk stratification and guiding treatment decisions. 

The REVEAL Risk Score takes into account various parameters including demographic data, medical history, clinical signs and symptoms, and results from diagnostic tests such as echocardiography and hemodynamics. 

It is important to note that this calculator is not applicable to patients with other types of pulmonary hypertension, such as those caused by lung diseases or hypoxia, or chronic thromboembolic pulmonary hypertension. It is also not intended for use in patients with congenital heart disease-associated PAH if they are younger than 18 years old.

REVEAL risk score for pulmonary arterial hypertension

# Criteria
 ## World Health Organization group 1 PAH subgroup
A. Associated PAH-connective tissue disease (+1)
B. Associated PAH-portopulmonary hypertension (+2)
C. Familial PAH (+2)
D. Other (+0)
## Renal insufficiency
E. Yes (+1)
F. No (+0)
## Male age > 60 years
G. Yes (+2)
H. No (+0)
## New York Heart Association/World Health Organization functional class
I. I (-2)
J. II (+0)
K. III (+1)
L. IV (+2)
## Systolic blood pressure, mmHg
M. >= 110 (+0)
N. < 110 (+1)
## Heart rate, bpm
O. <= 92 (+0)
P. > 92 (+1)
## 6-minute walk test
Q. >= 440 m (-1)
R. 165-440 m (+0)
S. < 165 m (+1)
## BNP, pg/mL / N-terminal pro-BNP if BNP is not available 
T. < 50 / < 300 (-2)
U. 50-180 / 300-1500 (+0)
V. > 180 / > 1,500 (+1)
## Pericardial effusion on echocardiogram
W. Yes (+1)
X. No (+0)
## Diffusing capacity of lung for carbon monoxide on pulmonary function test
Y. >= 80% (-1)
Z. 33-79% (+0)
AA. <= 32% (+1)
## Mean right atrial pressure > 20 mmHg within 1 year on right heart catheterization
AB. Yes (+1)
AC. No (+0)
## Pulmonary vascular resistance > 32 Wood units on right heart catheterization
AD. Yes (+2)
AE. No (+0)

# Conditions
- score <= 7
- score == 8
- score == 9
- score <= 11
- score >= 12
- score == 0

The BODE Index, or the Body-Mass Index, Obstruction of Airflow, Dyspnea, and Exercise Capacity Index, is a scoring system used for patients with Chronic Obstructive Pulmonary Disease (COPD). This calculator is designed to predict the survival rate of patients with COPD, and it is used to stratify the severity of the disease and guide treatment decisions. 

The BODE Index takes into account four factors: the Body-Mass Index (BMI), the degree of airflow Obstruction measured by Forced Expiratory Volume in one second (FEV1), the level of Dyspnea assessed by the Modified Medical Research Council (MMRC) Dyspnea Scale, and Exercise capacity measured by the distance covered in a 6-minute walk test. 

The BODE Index is applicable to patients diagnosed with COPD. It is not suitable for patients with other types of respiratory diseases or conditions that might affect the parameters measured, such as severe cardiac disease, musculoskeletal disorders, or neurological conditions that could impact the 6-minute walk test. It is also not appropriate for use in patients who have not been definitively diagnosed with COPD.

BODE index for survival of COPD

# Criteria
 ## FEV₁ (% of predicted)
A. >= 65% (+0)
B. 50-64% (+1)
C. 36-49% (+2)
D. <= 35% (+3)
## Distance walked in 6-Minute Walk Distance
E. >= 350 m (+0)
F. 250-349 m (+1)
G. 150-249 m (+2)
H. <= 149 m (+3)
## MMRC Dyspnea Scale
I. Dyspnea only with strenuous exercise (+0)
J. Dyspnea when hurrying or walking up a slight hill (+0)
K. Walks slower than people of same age because of dyspnea or stops for breath when walking at own pace (+1)
L. Short of breath after walking a few minutes or 100 yards (91 m) (+2)
M. Too breathless to leave house or breathless when dressing (+3)
## Body mass index
N. > 21 (+0)
O. <= 21 (+1)

# Conditions
- score <= 2
- score <= 4
- score <= 6
- score <= 10
- score == 0